Self pay and could cry over the amount, couple of questions

[mmorris4 14]

Hello

We have united health care but weightless surgery is NOT covered. I have a hiatal hernia that will be fixed during my sleeve surgery. I was hoping that a bulk of the cost of surgery would be covered by my insurance now due to the hernia, ie-hostpial stay and anesthesiologist (2 huge expenses). I went today for another dr appt and they informed me that i have to pay $26,000 which is the cost of the sleeve and that includes the hospital stay and anesthesiologist. AND it has to be paid in full prior to surgery (set for april). I guess i just don't understand why the things my insurance WILL cover can't be deducted from the $26K, the office couldn't give me a answer which was really frustrating. My insurance company HAS paid for all my tests (minus my deductible). I hope this makes sense. SO, one of my questions is, how much was everyones surgery for self pay? This just seems like an awful lot.

[OutsideMatchInside 10,166]

That is a ridiculous amount. I am guessing you are in the Chicago area? Even if you are paying cash, they could give you the insurance rates.

My surgery cost around 38K, at least that is what they billed, but the insurance rate that BCBSIL paid was just under 12K.

If United was paying for your surgery, I doubt the negotiated rate would be 26K.

I would not pay 26K out of pocket. Why not try Blossom Bariatrics in Vegas? There are places in STL that are more affordable. I think that cash pay is around 12K in STL at http://mynewselfbariatrics.com/

Why not try U of I.

Also is Dr Mikhail the Dr that had the big lawsuit last year over a gastric bypass gone wrong?

Edited February 27, 2016 by OutsideMatchInside

[Kindle 8,667]

My insurance didn't cover WLS at all. I paid $6500 at Obesity Control Center in TJ. Dr. Ariel Ortiz is a Fellow of the American College of Surgeons and a Bariatric Surgeon of Excellence. His facility is an International Center of Excellence. He's proctored dozens of US and Canadian surgeons in laparoscopic technique, performed over 16,000 bariatric surgeries and has a complication rate 1/10 that of the US average. I had an easy, pain free recovery and was back to work in 7 days. Excellent postop communication and even at 2 years out they continue to monitor my progress. My PCP is so impressed he is recommending OCC to his patients that dont have WLS insurance.

If you can't get things straightened out with your local doctor and insurance, you should look at the great surgical options offered elsewhere.

[perforce 243]

I agree with the idea to look elsewhere, I know the idea of going out of country can be daunting, but better self pay at somewhere reputable and have no surprises with bills later.

Sent from my SM-G900H using the BariatricPal App

[Kimi Siar 1]

Cash pay in STL for me is $18,000.00 just for the surgeon so all together on self pay sounds about right to me. Vegas has self pay deals around $11,000-$14,000 all inclusive

Edited February 27, 2016 by Kimi Siar

[SHAMROCK16 1]

I am self pay and just was quoted $23,000. The dr said to not even try to get the hernia repaired at the same time as my insurance sees that as a way to getting WLS paid for and will not pay for it.

I live in Wisconsin and it's the worst state to get insurance to mandatory pay and to also with one of the highest costs for WLS. I am now considering going to the Mexico Tijuana practice promoted on this site. For $5,000 +/- it's a great deal!

Am I ok to do this? I've researched them A LOT, but my gut still says it's not right to get surgery in another country.

[mmorris4 14]

That is a ridiculous amount. I am guessing you are in the Chicago area? Even if you are paying cash, they could give you the insurance rates.

My surgery cost around 38K, at least that is what they billed, but the insurance rate that BCBSIL paid was just under 12K.

If United was paying for your surgery, I doubt the negotiated rate would be 26K.

I would not pay 26K out of pocket. Why not try Blossom Bariatrics in Vegas? There are places in STL that are more affordable. I think that cash pay is around 12K in STL at http://mynewselfbariatrics.com/

Why not try U of I.

Also is Dr Mikhail the Dr that had the big lawsuit last year over a gastric bypass gone wrong?

Thank you. I don't know if that is the Dr. with a big lawsuit. I haven't come across anything

[OutsideMatchInside 10,166]

http://www.chicagotribune.com/suburbs/post-tribune/news/ct-ptb-gastric-bypass-damages-st-0501-20150430-story.html

If the Dr in your profile is correct.

[con con 142]

My surgery cost $89,000.00. I almost fell over when I saw that on my EOB. Two day hospital stay and a hernia repair. Granted I live in the most expensive city in the states. But that price was unbelievable. Thankfully the sleeve was covered under my policy.Gl

[mmorris4 14]

http://www.chicagotribune.com/suburbs/post-tribune/news/ct-ptb-gastric-bypass-damages-st-0501-20150430-story.html

If the Dr in your profile is correct.

Yes, i did find it, thanks. That doesn't change my view on him though.

[Emilie.Lancaster 189]

I was self pay in Atlanta, 14k. It was outpatient, and fast. Within three weeks, I went from initial consultation to surgery. I ended up with an unfortunate and unforseen complication involving my pain management, and ended up in the hospital for 2days, which insurance covered, remarkably enough. Have a friend who paid 7500 in Mexico and never had a problem.

[OutsideMatchInside 10,166]

Can you buy a plan on the marketplace? The marketplace plans in Illinois cover bariatric surgery.

[because 63]

12,000 for everything. In Kansas City.

[MaryinNOLA 8]

I was sleeved on February 24th in New Orleans and my in all self pay was only $10,500 which included the hernia and 1 year post op appointments or additional hospital stays for complications.

[mmorris4 14]

Thank you for all the responses